Abstract: A 25-year-old woman presented with a chronically sore mouth. Her soreness appeared one week after a skin rash appeared on her scalp, buttocks and abdomen. The patient suffered only from osteoarthritis and in crisis used piroxicam tablets. Clinical examination revealed oral malodour (halitosis) associated with a large superficial ulceration in her lower lip (Figure 1), a white coated, partially depapillated tongue, with painful red areas of ulcerations in her dorsum, buccal mucosae and floor of mouth. Together with the oral ulcers, a few large flaccid skin bullae were seen. Biopsy from the tongue near to the ulceration revealed epithelial acantholysis.